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Hampsey E, Perkins A, Young AH. BNC210: an investigational α7-nicotinic acetylcholine receptor modulator for the treatment of anxiety disorders. Expert Opin Investig Drugs 2023; 32:277-282. [PMID: 36927202 DOI: 10.1080/13543784.2023.2192922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
INTRODUCTION Anxiety disorders are common, disabling psychiatric conditions associated with excessive worry, irritability, and physiological symptoms of stress. Following insufficient response to psychological therapies, first-line pharmacological treatments for anxiety disorders suffer from inconsistent efficacy, addiction, and intolerable side-effect profiles (e.g. sedation), especially when used inappropriately or contrary to evidence-based guidelines. Developing anxiolytics acting via cholinergic modulation may provide novel options for the treatment of anxiety disorders, without the drawbacks of existing anxiolytics. AREAS COVERED We review pharmacological treatment of anxiety disorders and proposed mechanisms of action in relation to the associated neural circuitry. We then consider the mechanism of action, pharmacodynamics, and pharmacokinetics of the negative-allosteric modulator of the alpha7 nicotinic receptor BNC210, an investigational anxiolytic so far employed in studies of those with social anxiety disorder, post-traumatic stress disorder, and agitation in hospitalized elderly. Lastly, we consider the environment of competitor compounds for this indication, and BNC210's place within it, in both the present and near-future. EXPERT OPINION : There is a relative paucity of data regarding BNC210, albeit the small amount of mostly non-peer reviewed data indicate it is a well-tolerated, effective anxiolytic. Phase III trials are required for proper appraisal of its utility.
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Affiliation(s)
- Elliot Hampsey
- Centre for Affective Disorders, King's College London, London, UK
| | - Adam Perkins
- Centre for Affective Disorders, King's College London, London, UK
| | - Allan H Young
- Centre for Affective Disorders, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
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2
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Juza R, Musilek K, Mezeiova E, Soukup O, Korabecny J. Recent advances in dopamine D 2 receptor ligands in the treatment of neuropsychiatric disorders. Med Res Rev 2023; 43:55-211. [PMID: 36111795 DOI: 10.1002/med.21923] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 07/29/2022] [Accepted: 08/09/2022] [Indexed: 02/04/2023]
Abstract
Dopamine is a biologically active amine synthesized in the central and peripheral nervous system. This biogenic monoamine acts by activating five types of dopamine receptors (D1-5 Rs), which belong to the G protein-coupled receptor family. Antagonists and partial agonists of D2 Rs are used to treat schizophrenia, Parkinson's disease, depression, and anxiety. The typical pharmacophore with high D2 R affinity comprises four main areas, namely aromatic moiety, cyclic amine, central linker and aromatic/heteroaromatic lipophilic fragment. From the literature reviewed herein, we can conclude that 4-(2,3-dichlorophenyl), 4-(2-methoxyphenyl)-, 4-(benzo[b]thiophen-4-yl)-1-substituted piperazine, and 4-(6-fluorobenzo[d]isoxazol-3-yl)piperidine moieties are critical for high D2 R affinity. Four to six atoms chains are optimal for D2 R affinity with 4-butoxyl as the most pronounced one. The bicyclic aromatic/heteroaromatic systems are most frequently occurring as lipophilic appendages to retain high D2 R affinity. In this review, we provide a thorough overview of the therapeutic potential of D2 R modulators in the treatment of the aforementioned disorders. In addition, this review summarizes current knowledge about these diseases, with a focus on the dopaminergic pathway underlying these pathologies. Major attention is paid to the structure, function, and pharmacology of novel D2 R ligands, which have been developed in the last decade (2010-2021), and belong to the 1,4-disubstituted aromatic cyclic amine group. Due to the abundance of data, allosteric D2 R ligands and D2 R modulators from patents are not discussed in this review.
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Affiliation(s)
- Radomir Juza
- Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic.,Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Kamil Musilek
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic.,Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Eva Mezeiova
- Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic.,Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Ondrej Soukup
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jan Korabecny
- Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic.,Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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3
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Trait anxiety is associated with amygdala expectation and caloric taste receipt response across eating disorders. Neuropsychopharmacology 2023; 48:380-390. [PMID: 36100656 PMCID: PMC9750993 DOI: 10.1038/s41386-022-01440-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 12/26/2022]
Abstract
Anxious traits are elevated in eating disorders (EDs), are considered risk factors for ED development, and trait anxiety has been linked to ED psychopathology. How trait anxiety relates to ED neurobiology is not well understood. In this study 197 individuals across the ED spectrum (anorexia nervosa n = 91; other specified EDs n = 34; bulimia nervosa n = 56; binge ED n = 16), and 120 healthy controls were assessed for anxious traits and learned to expect and receive caloric or neutral taste stimuli during brain imaging. Amygdala sucrose expectation response differed across groups (Wilk's lambda = 0.945, p = 0.023), and was higher on the left in anorexia nervosa compared to healthy controls (p = 0.002). Expected sucrose receipt response across taste reward regions was not different between groups. In the ED sample, trait anxiety negatively moderated the relationship between amygdala expectation and right dorsal (p = 0.0062) and ventral (p = 0.0046) anterior insula receipt response. A subgroup analysis showed similar results for anorexia nervosa, and partially in bulimia nervosa. Across EDs, appetitive motivation correlated positively with bilateral orbitofrontal cortex, caudate head, and ventral striatal sucrose receipt response (r = 0.215 to 0.179, p = 0.002 to 0.012). Across the study sample, trait anxiety showed an inverted-U-shaped relationship with right (r = 0.147, p = 0.034) and left (r = 0.162, p = 0.016) amygdala expectation response. Amygdala sucrose expectation response is elevated in anorexia nervosa, correlates with sucrose receipt response, and this relationship is negatively moderated by trait anxiety across EDs. Trait anxiety may have an important role in how expectation drives taste stimulus receipt brain response and perhaps food approach in individuals with EDs.
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4
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The Impact of Emotion Regulation on the Relationship Between Momentary Negative Affect and End-of-Day Worry and Rumination. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10339-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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5
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Korem N, Duek O, Ben-Zion Z, Kaczkurkin AN, Lissek S, Orederu T, Schiller D, Harpaz-Rotem I, Levy I. Emotional numbing in PTSD is associated with lower amygdala reactivity to pain. Neuropsychopharmacology 2022; 47:1913-1921. [PMID: 35945274 PMCID: PMC9485255 DOI: 10.1038/s41386-022-01405-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/01/2022] [Accepted: 07/15/2022] [Indexed: 11/09/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with altered pain perception, namely increased pain threshold and higher pain response. While pain consists of physiological and affective components, affective components are often overlooked. Similar patterns of increased threshold-high response in PTSD were shown in response to emotional stimuli, i.e., emotional numbing. As both emotional numbing and pain processing are modulated by the amygdala, we aimed to examine whether individuals diagnosed with PTSD show lower amygdala activation to pain compared with combat controls, and whether the amygdala responses to pain correlates with emotional numbing. To do so, two independent samples of veterans (original study: 44 total (20 PTSD); conceptual replication study: 40 total (20 PTSD)) underwent threat conditioning, where a conditioned stimulus (CS+; visual stimulus) was paired with an unconditioned stimulus (US; electric-shock). We contrasted the amygdala activity to the CS + US pairing with the CS+ presented alone and correlated it with emotional numbing severity. In both samples, the PTSD group showed a robust reduction in amygdala reactivity to shock compared to the Combat Controls group. Furthermore, amygdala activation was negatively correlated with emotional numbing severity. These patterns were unique to the amygdala, and did not appear in comparison to a control region, the insula, a pivotal region for the processing of pain. To conclude, amygdala response to pain is lower in individuals with PTSD, and is associated with emotional numbing symptoms. Lower amygdala reactivity to mild pain may contribute to the "all-or-none" reaction to stressful situations often observed in PTSD.
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Affiliation(s)
- Nachshon Korem
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, 06511, USA.
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA.
- Yale University School of Medicine, Departments of Comparative Medicine and Neuroscience, New Haven, CT, 06511, USA.
| | - Or Duek
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, 06511, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Ziv Ben-Zion
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, 06511, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | | | - Shmuel Lissek
- Department of Psychology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Temidayo Orederu
- The Nash Family Department of Neuroscience, Department of Psychiatry, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Daniela Schiller
- The Nash Family Department of Neuroscience, Department of Psychiatry, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Ilan Harpaz-Rotem
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, 06511, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Yale University Department of Psychology, New Haven, CT, 06511, USA
- Wu Tsai Institute, Yale University New Haven, New Haven, CT, 06510, USA
| | - Ifat Levy
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Yale University School of Medicine, Departments of Comparative Medicine and Neuroscience, New Haven, CT, 06511, USA
- Yale University Department of Psychology, New Haven, CT, 06511, USA
- Wu Tsai Institute, Yale University New Haven, New Haven, CT, 06510, USA
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6
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Geurts DEM, Van den Heuvel TJ, Huys QJM, Verkes RJ, Cools R. Amygdala response predicts clinical symptom reduction in patients with borderline personality disorder: A pilot fMRI study. Front Behav Neurosci 2022; 16:938403. [PMID: 36110290 PMCID: PMC9468714 DOI: 10.3389/fnbeh.2022.938403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Borderline personality disorder (BPD) is a prevalent, devastating, and heterogeneous psychiatric disorder. Treatment success is highly variable within this patient group. A cognitive neuroscientific approach to BPD might contribute to precision psychiatry by identifying neurocognitive factors that predict who will benefit from a specific treatment. Here, we build on observations that BPD is accompanied by the enhanced impact of the aversive effect on behavior and abnormal neural signaling in the amygdala. We assessed whether BPD is accompanied by abnormal aversive regulation of instrumental behavior and associated neural signaling, in a manner that is predictive of symptom reduction after therapy. We tested a clinical sample of 15 female patients with BPD, awaiting dialectical behavior therapy (DBT), and 16 matched healthy controls using fMRI and an aversive Pavlovian-to-instrumental transfer (PIT) task that assesses how instrumental behaviors are influenced by aversive Pavlovian stimuli. Patients were assessed 1 year after the start of DBT to quantify changes in BPD symptom severity. At baseline, behavioral aversive PIT and associated neural signaling did not differ between groups. However, the BOLD signal in the amygdala measured during aversive PIT was associated with symptom reduction at 1-year follow-up: higher PIT-related aversive amygdala signaling before treatment was associated with reduced clinical improvement at follow-up. Thus, within the evaluated group of BPD patients, the BOLD signal in the amygdala before treatment was related to clinical symptom reduction 1 year after the start of treatment. The results suggest that less PIT-related responsiveness of the amygdala increases the chances of treatment success. We note that the relatively small sample size is a limitation of this study and that replication is warranted.
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Affiliation(s)
- Dirk E. M. Geurts
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Thom J. Van den Heuvel
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Scelta, Expert Centre for Personality Disorders, GGNet, Nijmegen, Netherlands
| | - Quentin J. M. Huys
- Mental Health Neuroscience Department, Division of Psychiatry and Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Institute of Neurology, University College London, London, United Kingdom
| | - Robbert J. Verkes
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Kairos Center for Forensic Psychiatry, Pro Persona Mental Health, Nijmegen, Netherlands
| | - Roshan Cools
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
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7
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Rosen JB, Schulkin J. Hyperexcitability: From Normal Fear to Pathological Anxiety and Trauma. Front Syst Neurosci 2022; 16:727054. [PMID: 35993088 PMCID: PMC9387392 DOI: 10.3389/fnsys.2022.727054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Hyperexcitability in fear circuits is suggested to be important for development of pathological anxiety and trauma from adaptive mechanisms of fear. Hyperexcitability is proposed to be due to acquired sensitization in fear circuits that progressively becomes more severe over time causing changing symptoms in early and late pathology. We use the metaphor and mechanisms of kindling to examine gains and losses in function of one excitatory and one inhibitory neuropeptide, corticotrophin releasing factor and somatostatin, respectively, to explore this sensitization hypothesis. We suggest amygdala kindling induced hyperexcitability, hyper-inhibition and loss of inhibition provide clues to mechanisms for hyperexcitability and progressive changes in function initiated by stress and trauma.
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Affiliation(s)
- Jeffrey B. Rosen
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
- *Correspondence: Jeffrey B. Rosen,
| | - Jay Schulkin
- School of Medicine, University of Washington, Seattle, WA, United States
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Johnson C, Kretsge LN, Yen WW, Sriram B, O'Connor A, Liu RS, Jimenez JC, Phadke RA, Wingfield KK, Yeung C, Jinadasa TJ, Nguyen TPH, Cho ES, Fuchs E, Spevack ED, Velasco BE, Hausmann FS, Fournier LA, Brack A, Melzer S, Cruz-Martín A. Highly unstable heterogeneous representations in VIP interneurons of the anterior cingulate cortex. Mol Psychiatry 2022; 27:2602-2618. [PMID: 35246635 PMCID: PMC11128891 DOI: 10.1038/s41380-022-01485-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 11/09/2022]
Abstract
A hallmark of the anterior cingulate cortex (ACC) is its functional heterogeneity. Functional and imaging studies revealed its importance in the encoding of anxiety-related and social stimuli, but it is unknown how microcircuits within the ACC encode these distinct stimuli. One type of inhibitory interneuron, which is positive for vasoactive intestinal peptide (VIP), is known to modulate the activity of pyramidal cells in local microcircuits, but it is unknown whether VIP cells in the ACC (VIPACC) are engaged by particular contexts or stimuli. Additionally, recent studies demonstrated that neuronal representations in other cortical areas can change over time at the level of the individual neuron. However, it is not known whether stimulus representations in the ACC remain stable over time. Using in vivo Ca2+ imaging and miniscopes in freely behaving mice to monitor neuronal activity with cellular resolution, we identified individual VIPACC that preferentially activated to distinct stimuli across diverse tasks. Importantly, although the population-level activity of the VIPACC remained stable across trials, the stimulus-selectivity of individual interneurons changed rapidly. These findings demonstrate marked functional heterogeneity and instability within interneuron populations in the ACC. This work contributes to our understanding of how the cortex encodes information across diverse contexts and provides insight into the complexity of neural processes involved in anxiety and social behavior.
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Affiliation(s)
- Connor Johnson
- Neurobiology Section in the Department of Biology, Boston University, Boston, MA, USA
| | - Lisa N Kretsge
- The Graduate Program for Neuroscience, Boston University, Boston, MA, USA
- Neurophotonics Center, Boston University, Boston, MA, USA
| | - William W Yen
- Neurobiology Section in the Department of Biology, Boston University, Boston, MA, USA
| | | | - Alexandra O'Connor
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - Ruichen Sky Liu
- MS in Statistical Practice Program, Boston University, Boston, MA, USA
| | - Jessica C Jimenez
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Rhushikesh A Phadke
- Molecular Biology, Cell Biology and Biochemistry Program, Boston University, Boston, MA, USA
| | - Kelly K Wingfield
- Neurophotonics Center, Boston University, Boston, MA, USA
- Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA, USA
| | - Charlotte Yeung
- Neurobiology Section in the Department of Biology, Boston University, Boston, MA, USA
| | - Tushare J Jinadasa
- Neurobiology Section in the Department of Biology, Boston University, Boston, MA, USA
| | - Thanh P H Nguyen
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - Eun Seon Cho
- Neurobiology Section in the Department of Biology, Boston University, Boston, MA, USA
| | - Erelle Fuchs
- Neurobiology Section in the Department of Biology, Boston University, Boston, MA, USA
| | - Eli D Spevack
- Neurobiology Section in the Department of Biology, Boston University, Boston, MA, USA
| | - Berta Escude Velasco
- Neurobiology Section in the Department of Biology, Boston University, Boston, MA, USA
| | - Frances S Hausmann
- Neurobiology Section in the Department of Biology, Boston University, Boston, MA, USA
| | - Luke A Fournier
- Neurobiology Section in the Department of Biology, Boston University, Boston, MA, USA
| | - Alison Brack
- Molecular Biology, Cell Biology and Biochemistry Program, Boston University, Boston, MA, USA
| | - Sarah Melzer
- Department of Neurobiology, Howard Hughes Medical Institute, Harvard Medical School, Boston, MA, USA
| | - Alberto Cruz-Martín
- Neurobiology Section in the Department of Biology, Boston University, Boston, MA, USA.
- Neurophotonics Center, Boston University, Boston, MA, USA.
- Molecular Biology, Cell Biology and Biochemistry Program, Boston University, Boston, MA, USA.
- Center for Systems Neuroscience, Boston University, Boston, MA, USA.
- The Center for Network Systems Biology, Boston University, Boston, MA, USA.
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9
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Qiao Z, Pan DN, Hoid D, van Winkel R, Li X. When the approaching threat is uncertain: Dynamics of defensive motivation and attention in trait anxiety. Psychophysiology 2022; 59:e14049. [PMID: 35307851 DOI: 10.1111/psyp.14049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 02/16/2022] [Accepted: 02/22/2022] [Indexed: 11/26/2022]
Abstract
Uncertainty of threat has been linked to anxiety, but little is known about how neurophysiological responses change as uncertain threats approach and whether trait anxiety modulates these changes. The current study was designed to explore aspects of the dynamics of defensive motivation (startle reflex elicited by acoustic startle probes), attention (probe N100 component of event-related potentials elicited by acoustic startle probes), and autonomic nervous system activity (heart rate) when the approaching threat was certain or uncertain in a variant of the threat probability task. Behavioral results showed that high-trait anxious individuals reported higher levels of anxiety than low-trait anxious individuals only under the uncertain threat condition. Electromyographic data showed that high-trait anxious individuals tended to produce a more pronounced startle reflex, especially when the uncertain threat was proximal. This pattern was not observed in low-trait anxious individuals. By examining early attention engagement through probe N100, we observed a similar pattern in relation to defensive motivation. Moreover, under the uncertain threat condition, high-trait anxious individuals yielded a greater deceleration of heart rate than low-trait anxious individuals. These results indicate a distinct modulation effect of trait anxiety in the dynamics of defensive motivation, attention, and the autonomic nervous system during the anticipation of uncertain threats.
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Affiliation(s)
- Zhiling Qiao
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.,KU Leuven, Department of Neuroscience, Research Group Psychiatry, Center for Clinical Psychiatry, Leuven, Belgium
| | - Dong-Ni Pan
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Delhii Hoid
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ruud van Winkel
- KU Leuven, Department of Neuroscience, Research Group Psychiatry, Center for Clinical Psychiatry, Leuven, Belgium.,UPC KU Leuven, Leuven, Belgium.,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Xuebing Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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10
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Namkung H, Thomas KL, Hall J, Sawa A. Parsing neural circuits of fear learning and extinction across basic and clinical neuroscience: Towards better translation. Neurosci Biobehav Rev 2022; 134:104502. [PMID: 34921863 DOI: 10.1016/j.neubiorev.2021.12.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 12/22/2022]
Abstract
Over the past decades, studies of fear learning and extinction have advanced our understanding of the neurobiology of threat and safety learning. Animal studies can provide mechanistic/causal insights into human brain regions and their functional connectivity involved in fear learning and extinction. Findings in humans, conversely, may further enrich our understanding of neural circuits in animals by providing macroscopic insights at the level of brain-wide networks. Nevertheless, there is still much room for improvement in translation between basic and clinical research on fear learning and extinction. Through the lens of neural circuits, in this article, we aim to review the current knowledge of fear learning and extinction in both animals and humans, and to propose strategies to fill in the current knowledge gap for the purpose of enhancing clinical benefits.
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Affiliation(s)
- Ho Namkung
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Kerrie L Thomas
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK; School of Biosciences, Cardiff University, Cardiff, UK
| | - Jeremy Hall
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK; School of Medicine, Cardiff University, Cardiff, UK
| | - Akira Sawa
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21287, USA.
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11
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Sharp PB, Russek EM, Huys QJM, Dolan RJ, Eldar E. Humans perseverate on punishment avoidance goals in multigoal reinforcement learning. eLife 2022; 11:e74402. [PMID: 35199640 PMCID: PMC8912924 DOI: 10.7554/elife.74402] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 02/21/2022] [Indexed: 11/20/2022] Open
Abstract
Managing multiple goals is essential to adaptation, yet we are only beginning to understand computations by which we navigate the resource demands entailed in so doing. Here, we sought to elucidate how humans balance reward seeking and punishment avoidance goals, and relate this to variation in its expression within anxious individuals. To do so, we developed a novel multigoal pursuit task that includes trial-specific instructed goals to either pursue reward (without risk of punishment) or avoid punishment (without the opportunity for reward). We constructed a computational model of multigoal pursuit to quantify the degree to which participants could disengage from the pursuit goals when instructed to, as well as devote less model-based resources toward goals that were less abundant. In general, participants (n = 192) were less flexible in avoiding punishment than in pursuing reward. Thus, when instructed to pursue reward, participants often persisted in avoiding features that had previously been associated with punishment, even though at decision time these features were unambiguously benign. In a similar vein, participants showed no significant downregulation of avoidance when punishment avoidance goals were less abundant in the task. Importantly, we show preliminary evidence that individuals with chronic worry may have difficulty disengaging from punishment avoidance when instructed to seek reward. Taken together, the findings demonstrate that people avoid punishment less flexibly than they pursue reward. Future studies should test in larger samples whether a difficulty to disengage from punishment avoidance contributes to chronic worry.
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Affiliation(s)
- Paul B Sharp
- The Hebrew University of JerusalemJerusalemIsrael
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College LondonLondonUnited Kingdom
- Wellcome Centre for Human Neuroimaging, University College LondonLondonUnited Kingdom
| | - Evan M Russek
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College LondonLondonUnited Kingdom
- Wellcome Centre for Human Neuroimaging, University College LondonLondonUnited Kingdom
| | - Quentin JM Huys
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College LondonLondonUnited Kingdom
- Division of Psychiatry, University College LondonLondonUnited Kingdom
| | - Raymond J Dolan
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College LondonLondonUnited Kingdom
- Wellcome Centre for Human Neuroimaging, University College LondonLondonUnited Kingdom
| | - Eran Eldar
- The Hebrew University of JerusalemJerusalemIsrael
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12
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Associations between GAD symptom severity and error monitoring depend on neural quenching variability. MOTIVATION AND EMOTION 2022. [DOI: 10.1007/s11031-021-09923-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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13
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Kenwood MM, Kalin NH, Barbas H. The prefrontal cortex, pathological anxiety, and anxiety disorders. Neuropsychopharmacology 2022; 47:260-275. [PMID: 34400783 PMCID: PMC8617307 DOI: 10.1038/s41386-021-01109-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 02/07/2023]
Abstract
Anxiety is experienced in response to threats that are distal or uncertain, involving changes in one's subjective state, autonomic responses, and behavior. Defensive and physiologic responses to threats that involve the amygdala and brainstem are conserved across species. While anxiety responses typically serve an adaptive purpose, when excessive, unregulated, and generalized, they can become maladaptive, leading to distress and avoidance of potentially threatening situations. In primates, anxiety can be regulated by the prefrontal cortex (PFC), which has expanded in evolution. This prefrontal expansion is thought to underlie primates' increased capacity to engage high-level regulatory strategies aimed at coping with and modifying the experience of anxiety. The specialized primate lateral, medial, and orbital PFC sectors are connected with association and limbic cortices, the latter of which are connected with the amygdala and brainstem autonomic structures that underlie emotional and physiological arousal. PFC pathways that interface with distinct inhibitory systems within the cortex, the amygdala, or the thalamus can regulate responses by modulating neuronal output. Within the PFC, pathways connecting cortical regions are poised to reduce noise and enhance signals for cognitive operations that regulate anxiety processing and autonomic drive. Specialized PFC pathways to the inhibitory thalamic reticular nucleus suggest a mechanism to allow passage of relevant signals from thalamus to cortex, and in the amygdala to modulate the output to autonomic structures. Disruption of specific nodes within the PFC that interface with inhibitory systems can affect the negative bias, failure to regulate autonomic arousal, and avoidance that characterize anxiety disorders.
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Affiliation(s)
- Margaux M Kenwood
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Neuroscience Training Program at University of Wisconsin-Madison, Madison, USA
| | - Ned H Kalin
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Neuroscience Training Program at University of Wisconsin-Madison, Madison, USA
- Wisconsin National Primate Center, Madison, WI, USA
| | - Helen Barbas
- Neural Systems Laboratory, Department of Health Sciences, Boston University, Boston, MA, USA.
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.
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14
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Clarkson T, Karvay Y, Quarmley M, Jarcho JM. Sex differences in neural mechanisms of social and non-social threat monitoring. Dev Cogn Neurosci 2021; 52:101038. [PMID: 34814040 PMCID: PMC8608892 DOI: 10.1016/j.dcn.2021.101038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 10/26/2021] [Accepted: 11/16/2021] [Indexed: 11/17/2022] Open
Abstract
Adolescent males and females differ in their responses to social threat. Yet, threat processing is often probed in non-social contexts using the error-related negativity (ERN; Flanker EEG Task), which does not yield sex-specific outcomes. fMRI studies show inconsistent patterns of sex-specific neural engagement during threat processing. Thus, the relation between threat processing in non-social and social contexts across sexes and the effects perceived level of threat on brain function are unclear. We tested the interactive effect of non-social threat-vigilance (ERN), sex (N = 69; Male=34; 11–14-year-olds), and perceived social threat on brain function while anticipating feedback from ‘unpredictable’, ‘nice’, or ‘mean’ purported peers (fMRI; Virtual School Paradigm). Whole-brain analyses revealed differential engagement of precentral and inferior frontal gyri, putamen, anterior cingulate cortex, and insula. Among males with more threat-vigilant ERNs, greater social threat was associated with increased activation when anticipating unpredictable feedback. Region of interest analyses revealed this same relation in females in the amygdala and anterior hippocampus when anticipating mean feedback. Thus, non-social threat vigilance relates to neural engagement depending on perceived social threat, but peer-based social contexts and brain regions engaged, differ across sexes. This may partially explain divergent psychosocial outcomes in adolescence. Responses to social threat differ by sex and likely influence peer victimization. Threat processing is often probed in nonsocial contexts and is not sex-specific. Responses to type of social threat differed by sex, but relate to response to non-social threat. Brain regions engaged during social threat differ by sex. Perceived social threat relate to in-vivo peer victimization in both sexes.
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15
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Bryant RA, Erlinger M, Felmingham K, Klimova A, Williams LM, Malhi G, Forbes D, Korgaonkar MS. Reappraisal-related neural predictors of treatment response to cognitive behavior therapy for post-traumatic stress disorder. Psychol Med 2021; 51:2454-2464. [PMID: 32366351 DOI: 10.1017/s0033291720001129] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although trauma-focused cognitive behavior therapy (TF-CBT) is the frontline treatment for post-traumatic stress disorder (PTSD), one-third of patients are treatment non-responders. To identify neural markers of treatment response to TF-CBT when participants are reappraising aversive material. METHODS This study assessed PTSD patients (n = 37) prior to TF-CBT during functional magnetic brain resonance imaging (fMRI) when they reappraised or watched traumatic images. Patients then underwent nine sessions of TF-CBT, and were then assessed for symptom severity on the Clinician-Administered PTSD Scale. FMRI responses for cognitive reappraisal and emotional reactivity contrasts of traumatic images were correlated with the reduction of PTSD severity from pretreatment to post-treatment. RESULTS Symptom improvement was associated with decreased activation of the left amygdala during reappraisal, but increased activation of bilateral amygdala and hippocampus during emotional reactivity prior to treatment. Lower connectivity of the left amygdala to the subgenual anterior cingulate cortex, pregenual anterior cingulate cortex, and right insula, and that between the left hippocampus and right amygdala were also associated with symptom improvement. CONCLUSIONS These findings provide evidence that optimal treatment response to TF-CBT involves the capacity to engage emotional networks during emotional processing, and also to reduce the engagement of these networks when down-regulating emotions.
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Affiliation(s)
- Richard A Bryant
- University of New South Wales, School, Sydney, Australia
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, Australia
| | - May Erlinger
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, Australia
| | - Kim Felmingham
- Department of Psychological Medicine, University of Melbourne, Melbourne, Australia
| | - Aleksandra Klimova
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, Australia
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, San Francisco, USA
- Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC) VA Palo Alto Health Care System, San Francisco, USA
| | - Gin Malhi
- Department of Psychiatry, University of Sydney, Sydney, Australia
| | - David Forbes
- Phoenix Australia, University of Melbourne, Melbourne, Australia
| | - Mayuresh S Korgaonkar
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, Australia
- Department of Psychiatry, University of Sydney, Sydney, Australia
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16
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Shephard E, Stern ER, van den Heuvel OA, Costa DL, Batistuzzo MC, Godoy PB, Lopes AC, Brunoni AR, Hoexter MQ, Shavitt RG, Reddy JY, Lochner C, Stein DJ, Simpson HB, Miguel EC. Toward a neurocircuit-based taxonomy to guide treatment of obsessive-compulsive disorder. Mol Psychiatry 2021; 26:4583-4604. [PMID: 33414496 PMCID: PMC8260628 DOI: 10.1038/s41380-020-01007-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022]
Abstract
An important challenge in mental health research is to translate findings from cognitive neuroscience and neuroimaging research into effective treatments that target the neurobiological alterations involved in psychiatric symptoms. To address this challenge, in this review we propose a heuristic neurocircuit-based taxonomy to guide the treatment of obsessive-compulsive disorder (OCD). We do this by integrating information from several sources. First, we provide case vignettes in which patients with OCD describe their symptoms and discuss different clinical profiles in the phenotypic expression of the condition. Second, we link variations in these clinical profiles to underlying neurocircuit dysfunctions, drawing on findings from neuropsychological and neuroimaging studies in OCD. Third, we consider behavioral, pharmacological, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions. Finally, we suggest methods of testing this neurocircuit-based taxonomy as well as important limitations to this approach that should be considered in future research.
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Affiliation(s)
- Elizabeth Shephard
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. .,Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
| | - Emily R. Stern
- Department of Psychiatry, The New York University School of Medicine, New York, USA.,Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
| | - Odile A. van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Daniel L.C. Costa
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo C. Batistuzzo
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Priscilla B.G. Godoy
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Antonio C. Lopes
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Andre R. Brunoni
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo Q. Hoexter
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Roseli G. Shavitt
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Janardhan Y.C Reddy
- Department of Psychiatry OCD Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Christine Lochner
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - H. Blair Simpson
- Center for OCD and Related Disorders, New York State Psychiatric Institute and the Department of Psychiatry, Columbia University Irving Medical Center, New York New York
| | - Euripedes C. Miguel
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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17
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Dufford AJ, Salzwedel AP, Gilmore JH, Gao W, Kim P. Maternal trait anxiety symptoms, frontolimbic resting-state functional connectivity, and cognitive development in infancy. Dev Psychobiol 2021; 63:e22166. [PMID: 34292595 PMCID: PMC10775911 DOI: 10.1002/dev.22166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 06/13/2021] [Accepted: 06/22/2021] [Indexed: 11/07/2022]
Abstract
Exposure to maternal anxiety symptoms during infancy has been associated with difficulties in development and greater risk for developing anxiety later in life. Although previous studies have examined associations between prenatal maternal distress, infant brain development, and developmental outcomes, it is still largely unclear if there are associations between postnatal anxiety, infant brain development, and cognitive development in infancy. In this study, we used resting-state functional magnetic resonance imaging to examine the association between maternal anxiety symptoms and resting-state functional connectivity in the first year of life. We also examine the association between frontolimbic functional connectivity and infant cognitive development. The sample consisted of 21 infants (mean age = 24.15 months, SD = 4.17) that were scanned during their natural sleep using. We test the associations between maternal trait anxiety symptoms and amygdala-anterior cingulate cortex (ACC) functional connectivity, a neural circuit implicated in early life stress exposure. We also test the associations between amygdala-ACC connectivity and cognitive development. We found a significant negative association between maternal trait anxiety symptoms and left amygdala-right ACC functional connectivity (p < .05, false discovery rate corrected). We found a significant negative association between left amygdala-right ACC functional connectivity and infant cognitive development (p < .05). These findings have potential implications for understanding the role of postpartum maternal anxiety symptoms in functional brain and cognitive development in infancy.
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Affiliation(s)
| | - Andrew P. Salzwedel
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - John H. Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Wei Gao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Pilyoung Kim
- Department of Psychology, University of Denver, Denver, Colorado, USA
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18
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Kim N, Kim MJ. Altered Task-Evoked Corticolimbic Responsivity in Generalized Anxiety Disorder. Int J Mol Sci 2021; 22:ijms22073630. [PMID: 33807276 PMCID: PMC8037355 DOI: 10.3390/ijms22073630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022] Open
Abstract
Generalized anxiety disorder (GAD) is marked by uncontrollable, persistent worry and exaggerated response to uncertainty. Here, we review and summarize the findings from the GAD literature that employs functional neuroimaging methods. In particular, the present review focuses on task-based blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) studies. We find that select brain regions often regarded as a part of a corticolimbic circuit (e.g., amygdala, anterior cingulate cortex, prefrontal cortex) are consistently targeted for a priori hypothesis-driven analyses, which, in turn, shows varying degrees of abnormal BOLD responsivity in GAD. Data-driven whole-brain analyses show the insula and the hippocampus, among other regions, to be affected by GAD, depending on the task used in each individual study. Overall, while the heterogeneity of the tasks and sample size limits the generalizability of the findings thus far, some promising convergence can be observed in the form of the altered BOLD responsivity of the corticolimbic circuitry in GAD.
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Affiliation(s)
- Nayoung Kim
- Department of Psychology, Sungkyunkwan University, Seoul 03063, Korea;
| | - M. Justin Kim
- Department of Psychology, Sungkyunkwan University, Seoul 03063, Korea;
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon 16060, Korea
- Correspondence:
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19
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Hiser J, Schneider B, Koenigs M. Uncertainty Potentiates Neural and Cardiac Responses to Visual Stimuli in Anxiety Disorders. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:725-734. [PMID: 33592312 DOI: 10.1016/j.bpsc.2021.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Intolerance of uncertainty and worry about future events are cardinal features of anxiety. However, the neurobiological and physiological mechanisms underlying these characteristics of anxiety remain to be fully elucidated. METHODS Individuals with diagnosed anxiety disorders (n = 29, 22 female) and age-matched comparison subjects (n = 28, 17 female) completed a task in which pictures (aversive or neutral content) were preceded by cues indicating certainty or uncertainty about the emotional valence of the subsequent pictures. We assessed functional magnetic resonance imaging and heart rate activity with respect to the 1) cue period, 2) emotional valence of the pictures, and 3) modulatory effect of uncertainty on responses to subsequent pictures. RESULTS Individuals with anxiety disorders and comparison subjects exhibited similar functional magnetic resonance imaging and cardiac activity during the cue period and for the aversive versus neutral picture contrast. However, individuals with anxiety disorders exhibited greater modulatory effects of uncertainty on their responses to subsequent pictures. Specifically, they displayed greater functional magnetic resonance imaging activity in a number of cortical regions (visual cortex, anterior cingulate cortex, superior temporal gyrus, and anterior insula), as well as significantly reduced cardiac deceleration to pictures preceded by the uncertainty cue. CONCLUSIONS These findings suggest that heightened neural and autonomic reactivity to stimuli during conditions of uncertainty may be a key psychobiological mechanism of anxiety.
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Affiliation(s)
- Jaryd Hiser
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin; Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin.
| | - Brett Schneider
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin; Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin
| | - Michael Koenigs
- Department of Psychiatry, University of Wisconsin-Madison, Madison, Wisconsin
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20
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Walker LC. A balancing act: the role of pro- and anti-stress peptides within the central amygdala in anxiety and alcohol use disorders. J Neurochem 2021; 157:1615-1643. [PMID: 33450069 DOI: 10.1111/jnc.15301] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/18/2020] [Accepted: 01/06/2021] [Indexed: 12/21/2022]
Abstract
The central nucleus of the amygdala (CeA) is widely implicated as a structure that integrates both appetitive and aversive stimuli. While intrinsic CeA microcircuits primarily consist of GABAergic neurons that regulate amygdala output, a notable feature of the CeA is the heterogeneity of neuropeptides and neuropeptide/neuromodulator receptors that it expresses. There is growing interest in the role of the CeA in mediating psychopathologies, including stress and anxiety states and their interactions with alcohol use disorders. Within the CeA, neuropeptides and neuromodulators often exert pro- or anti- stress actions, which can influence anxiety and alcohol associated behaviours. In turn, alcohol use can cause adaptions within the CeA, which may render an individual more vulnerable to stress which is a major trigger of relapse to alcohol seeking. This review examines the neurocircuitry, neurochemical phenotypes and how pro- and anti-stress peptide systems act within the CeA to regulate anxiety and alcohol seeking, focusing on preclinical observations from animal models. Furthermore, literature exploring the targeting of genetically defined populations or neuronal ensembles and the role of the CeA in mediating sex differences in stress x alcohol interactions are explored.
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Affiliation(s)
- Leigh C Walker
- Florey Institute of Neuroscience and Mental Health, Parkville, Vic, Australia.,Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, Vic, Australia
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21
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Cholinergic modulation of disorder-relevant human defensive behaviour in generalised anxiety disorder. Transl Psychiatry 2021; 11:13. [PMID: 33414442 PMCID: PMC7791022 DOI: 10.1038/s41398-020-01141-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/14/2020] [Accepted: 11/27/2020] [Indexed: 11/23/2022] Open
Abstract
Drugs that are clinically effective against anxiety disorders modulate the innate defensive behaviour of rodents, suggesting these illnesses reflect altered functioning in brain systems that process threat. This hypothesis is supported in humans by the discovery that the intensity of threat-avoidance behaviour is altered by the benzodiazepine anxiolytic lorazepam. However, these studies used healthy human participants, raising questions as to their validity in anxiety disorder patients, as well as their generalisability beyond GABAergic benzodiazepine drugs. BNC210 is a novel negative allosteric modulator of the alpha 7 nicotinic acetylcholine receptor and we recently used functional Magnetic Resonance Imaging to show it reduced amygdala responses to fearful faces in generalised anxiety disorder patients. Here we report the effect of BNC210 on the intensity of threat-avoidance behaviour in 21 female GAD patients from the same cohort. We used the Joystick Operated Runway Task as our behavioural measure, which is a computerised human translation of the Mouse Defense Test Battery, and the Spielberger state anxiety inventory as our measure of state affect. Using a repeated-measures, within-subjects design we assessed the effect of BNC210 at two dose levels versus placebo (300 mg and 2000 mg) upon two types of threat-avoidance behaviour (Flight Intensity and Risk Assessment Intensity). We also tested the effects of 1.5 mg of the benzodiazepine lorazepam as an active control. BNC210 significantly reduced Flight Intensity relative to placebo and the low dose of BNC210 also significantly reduced self-reported state anxiety. Risk Assessment Intensity was not significantly affected. Results show both human defensive behaviour and state anxiety are influenced by cholinergic neurotransmission and there provide converging evidence that this system has potential as a novel target for anxiolytic pharmacotherapy.
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22
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Lai C, Ciacchella C, Pellicano GR, Altavilla D, Sambucini D, Paolucci T, Sorgi ML, Di Franco M, Saggini R, Aceto P. Different Electrophysiological Responses to Pain-Related Visual Stimuli Between Fibromyalgia and Chronic low Back Pain Women: A Pilot Case-Control Study. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2021; 5:24705470211046881. [PMID: 34988344 PMCID: PMC8723168 DOI: 10.1177/24705470211046881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/31/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Fibromyalgia is a chronic pain syndrome which occurs in the absence of an organic damage, whom causes is still unclear. Aims of this pilot study were to investigate the neural correlates of fibromyalgia in response to pain-related visual stimuli and explore the psychological differences among fibromyalgia, chronic low back pain (CLBP) and healthy conditions. METHODS After a clinical assessment, electrophysiological responses to pain-related visual stimuli were recorded using a 256-Hydrocel Geodesic-Sensor-Net. Event-related potentials (ERPs), standardised low-resolution electromagnetic tomography (sLORETA), and psychological (Symptom Checklist-90-Revised) data were analysed for a total sample of 23 women (5 healthy volunteers, 12 fibromyalgia patients, 6 CLBP patients). RESULTS The main finding was that fibromyalgia women reported a different brain response to pain-related visual stimuli on the frontal montage compared to women with CLBP (p = .028). Moreover, fibromyalgia women showed an increased activity mainly on the hippocampus (p = .003) and the posterior cingulate cortex (p ≤ .001) in response to algic stimuli compared to not algic ones. Lastly, these women presented higher scores on the somatization (p = .002), obsession-compulsion (p = .045), depression (p = .043) and positive symptom distress (p = .023) dimensions compared to the healthy women. CONCLUSIONS These preliminary results suggest that although the painful symptoms are similar, the central elaboration of pain could be different between women with fibromyalgia and those with CLBP. Moreover, these findings provide preliminary evidences about the great alert and the central sensitivity to pain-related information regarding fibromyalgia patients.
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Affiliation(s)
- Carlo Lai
- Department of Dynamic and Clinical
Psychology, and Health Studies, Sapienza University, Rome, Italy
| | - Chiara Ciacchella
- Department of Dynamic and Clinical
Psychology, and Health Studies, Sapienza University, Rome, Italy
| | - Gaia Romana Pellicano
- Department of Dynamic and Clinical
Psychology, and Health Studies, Sapienza University, Rome, Italy
| | - Daniela Altavilla
- Department of Philosophy, Communication
and Performing Arts, “Roma Tre” University, Rome, Italy
| | - Daniela Sambucini
- Department of Dynamic and Clinical
Psychology, and Health Studies, Sapienza University, Rome, Italy
| | - Teresa Paolucci
- Department of Oral and Biotechnological
Biomedical Sciences, Physical Medicine and Rehabilitation, University of G.
D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Maria Laura Sorgi
- Department of Clinical and Molecular
Medicine, Sant' Andrea University Hospital, Sapienza University
of, Rome, Italy
| | - Manuela Di Franco
- Rheumatology Unit, Department of Internal Medicine and Medical
Specialties, Sapienza University of Rome, Italy
| | - Raoul Saggini
- Department of Oral and Biotechnological
Biomedical Sciences, Physical Medicine and Rehabilitation, University of G.
D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Paola Aceto
- Department of Emergency,
anesthesiological and reanimation sciences, Fondazione Policlinico
Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Basic Biotechnological
Sciences, Intensive Care and Perioperative Clinics, University of Sacred
Heart, Rome, Italy
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23
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Strawn JR, Levine A. Treatment Response Biomarkers in Anxiety Disorders: From Neuroimaging to Neuronally-Derived Extracellular Vesicles and Beyond. Biomark Neuropsychiatry 2020; 3:100024. [PMID: 32974615 PMCID: PMC7508464 DOI: 10.1016/j.bionps.2020.100024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Multiple and diverse psychotherapeutic or psychopharmacologic treatments effectively reduce symptoms for many patients with anxiety disorders, but the trajectory and magnitude of response vary considerably. This heterogeneity of treatment response has invigorated the search for biomarkers of treatment response in anxiety disorders, across the lifespan. In this review, we summarize evidence for biomarkers of treatment response in children, adolescents and adults with generalized, separation and social anxiety disorders as well as panic disorder. We then discuss the relationship between these biomarkers of treatment response and the pathophysiology of anxiety disorders. Finally, we provide context for treatment response biomarkers of the future, including neuronally-derived extracellular vesicles in anxiety disorders and discuss challenges that must be overcome prior to the debut of treatment response biomarkers in the clinic. A number of promising treatment response biomarkers have been identified, although there is an urgent need to replicate findings and to identify which biomarkers might guide clinicians in selecting from available treatments rather than just simply identifying patients who may be less likely to respond to a given intervention.
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Affiliation(s)
- Jeffrey R. Strawn
- Department of Psychiatry and Behavioral Neuroscience; Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio
- Department of Pediatrics, Division of Child & Adolescent Psychiatry and Division of Clinical Pharmacology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Amir Levine
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY
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24
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Chien JH, Colloca L, Korzeniewska A, Meeker TJ, Bienvenu OJ, Saffer MI, Lenz FA. Behavioral, Physiological and EEG Activities Associated with Conditioned Fear as Sensors for Fear and Anxiety. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6751. [PMID: 33255916 PMCID: PMC7728331 DOI: 10.3390/s20236751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/03/2020] [Accepted: 11/10/2020] [Indexed: 11/16/2022]
Abstract
Anxiety disorders impose substantial costs upon public health and productivity in the USA and worldwide. At present, these conditions are quantified by self-report questionnaires that only apply to behaviors that are accessible to consciousness, or by the timing of responses to fear- and anxiety-related words that are indirect since they do not produce fear, e.g., Dot Probe Test and emotional Stroop. We now review the conditioned responses (CRs) to fear produced by a neutral stimulus (conditioned stimulus CS+) when it cues a painful laser unconditioned stimulus (US). These CRs include autonomic (Skin Conductance Response) and ratings of the CS+ unpleasantness, ability to command attention, and the recognition of the association of CS+ with US (expectancy). These CRs are directly related to fear, and some measure behaviors that are minimally accessible to consciousness e.g., economic scales. Fear-related CRs include non-phase-locked phase changes in oscillatory EEG power defined by frequency and time post-stimulus over baseline, and changes in phase-locked visual and laser evoked responses both of which include late potentials reflecting attention or expectancy, like the P300, or contingent negative variation. Increases (ERS) and decreases (ERD) in oscillatory power post-stimulus may be generalizable given their consistency across healthy subjects. ERS and ERD are related to the ratings above as well as to anxious personalities and clinical anxiety and can resolve activity over short time intervals like those for some moods and emotions. These results could be incorporated into an objective instrumented test that measures EEG and CRs of autonomic activity and psychological ratings related to conditioned fear, some of which are subliminal. As in the case of instrumented tests of vigilance, these results could be useful for the direct, objective measurement of multiple aspects of the risk, diagnosis, and monitoring of therapies for anxiety disorders and anxious personalities.
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Affiliation(s)
- Jui-Hong Chien
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21287-7713, USA; (J.-H.C.); (T.J.M.); (M.I.S.)
| | - Luana Colloca
- Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD 21201-1595, USA;
- Department of Anesthesiology, School of Medicine, University of Maryland, Baltimore, MD 21201-1595, USA
| | - Anna Korzeniewska
- Department of Neurology, Johns Hopkins University, Baltimore, MD 21287-7713, USA;
| | - Timothy J. Meeker
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21287-7713, USA; (J.-H.C.); (T.J.M.); (M.I.S.)
| | - O. Joe Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD 21287-7713, USA;
| | - Mark I. Saffer
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21287-7713, USA; (J.-H.C.); (T.J.M.); (M.I.S.)
| | - Fred A. Lenz
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD 21287-7713, USA; (J.-H.C.); (T.J.M.); (M.I.S.)
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Carlson HN, Weiner JL. The neural, behavioral, and epidemiological underpinnings of comorbid alcohol use disorder and post-traumatic stress disorder. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 157:69-142. [PMID: 33648676 DOI: 10.1016/bs.irn.2020.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Alcohol use disorder (AUD) and (PTSD) frequently co-occur and individuals suffering from this dual diagnosis often exhibit increased symptom severity and poorer treatment outcomes than those with only one of these diseases. Although there have been significant advances in our understanding of the neurobiological mechanisms underlying each of these disorders, the neural underpinnings of the comorbid condition remain poorly understood. This chapter summarizes recent epidemiological findings on comorbid AUD and PTSD, with a focus on vulnerable populations, the temporal relationship between these disorders, and the clinical consequences associated with the dual diagnosis. We then review animal models of the comorbid condition and emerging human and non-human animal research that is beginning to identify maladaptive neural changes common to both disorders, primarily involving functional changes in brain reward and stress networks. We end by proposing a neural framework, based on the emerging field of affective valence encoding, that may better explain the epidemiological and neural findings on AUD and PTSD.
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Affiliation(s)
- Hannah N Carlson
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jeff L Weiner
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States.
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Xia F, Kheirbek MA. Circuit-Based Biomarkers for Mood and Anxiety Disorders. Trends Neurosci 2020; 43:902-915. [PMID: 32917408 PMCID: PMC7606349 DOI: 10.1016/j.tins.2020.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/23/2020] [Accepted: 08/16/2020] [Indexed: 12/11/2022]
Abstract
Mood and anxiety disorders are complex heterogeneous syndromes that manifest in dysfunctions across multiple brain regions, cell types, and circuits. Biomarkers using brain-wide activity patterns in humans have proven useful in distinguishing between disorder subtypes and identifying effective treatments. In order to improve biomarker identification, it is crucial to understand the basic circuitry underpinning brain-wide activity patterns. Leveraging a large repertoire of techniques, animal studies have examined roles of specific cell types and circuits in driving maladaptive behavior. Recent advances in multiregion recording techniques, data-driven analysis approaches, and machine-learning-based behavioral analysis tools can further push the boundary of animal studies and bridge the gap with human studies, to assess how brain-wide activity patterns encode and drive emotional behavior. Together, these efforts will allow identifying more precise biomarkers to enhance diagnosis and treatment.
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Affiliation(s)
- Frances Xia
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Mazen A Kheirbek
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA; Neuroscience Graduate Program, University of California, San Francisco, San Francisco, CA, USA.; Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, USA; Center for Integrative Neuroscience, University of California, San Francisco, San Francisco, CA, USA.
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Juza R, Vlcek P, Mezeiova E, Musilek K, Soukup O, Korabecny J. Recent advances with 5-HT 3 modulators for neuropsychiatric and gastrointestinal disorders. Med Res Rev 2020; 40:1593-1678. [PMID: 32115745 DOI: 10.1002/med.21666] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/10/2019] [Accepted: 02/11/2020] [Indexed: 12/17/2022]
Abstract
Serotonin (5-hydroxytryptophan [5-HT]) is a biologically active amine expressed in platelets, in gastrointestinal (GI) cells and, to a lesser extent, in the central nervous system (CNS). This biogenic compound acts through the activation of seven 5-HT receptors (5-HT1-7 Rs). The 5-HT3 R is a ligand-gated ion channel belonging to the Cys-loop receptor family. There is a wide variety of 5-HT3 R modulators, but only receptor antagonists (known as setrons) have been used clinically for chemotherapy-induced nausea and vomiting and irritable bowel syndrome treatment. However, since the discovery of the setrons in the mid-1980s, a large number of studies have been published exploring new potential applications due their potency in the CNS and mild side effects. The results of these studies have revealed new potential applications, including the treatment of neuropsychiatric disorders such as schizophrenia, depression, anxiety, and drug abuse. In this review, we provide information related to therapeutic potential of 5-HT3 R antagonists on GI and neuropsychiatric disorders. The major attention is paid to the structure, function, and pharmacology of novel 5-HT3 R modulators developed over the past 10 years.
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Affiliation(s)
- Radomir Juza
- National Institute of Mental Health, Klecany, Czech Republic
- Department of Chemistry, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Premysl Vlcek
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Eva Mezeiova
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Kamil Musilek
- Department of Chemistry, University of Hradec Kralove, Hradec Kralove, Czech Republic
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Ondrej Soukup
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jan Korabecny
- National Institute of Mental Health, Klecany, Czech Republic
- Biomedical Research Centre, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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28
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Chen Y, Chen T, Cai X. Light-sensitive circuits related to emotional processing underlie the antidepressant neural targets of light therapy. Behav Brain Res 2020; 396:112862. [PMID: 32827569 DOI: 10.1016/j.bbr.2020.112862] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/13/2020] [Accepted: 08/11/2020] [Indexed: 02/05/2023]
Abstract
Since Aaron Beck proposed his cognitive model of depression, biased attention, biased processing, and biased rumination (different phases of biased cognition) have been considered as the key elements consistently linked with depression. Increasing evidence suggests that the functional failures in the "emotional processing system (EPS)" underlie the neurological foundation of the biased cognition of depression. Light therapy, a non-intrusive approach, exerts powerful effects on emotion and cognition and affects the activity, functional connectivity, and plasticity of multiple brain structures. Although numerous studies have reported its effectiveness in treating depression, the findings have not been integrated with Beck's cognitive model and EPS, and the neurobiological mechanisms of antidepressant light therapy remain largely unknown. In this review, integrated with the classical theories of Beck's cognitive model of depression and EPS, we identified the key neural circuits and abnormalities involved in the cognitive bias of depression and, accordingly, identified and depicted several light-sensitive circuits (LSCs, neural circuits in the EPS that are responsive to light stimulation) that may underlie the antidepressant neural targets of light therapy, as listed below: In summary, the LSCs above narrow down the research scope of identifying the neural targets of antidepressant light therapy and help elucidate the neuropsychological mechanism of antidepressant light therapy.
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Affiliation(s)
- Yaodong Chen
- School of Architecture and Design, Southwest JiaoTong University, Chengdu, China.
| | - Taolin Chen
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xueli Cai
- School of Architecture and Design, Southwest JiaoTong University, Chengdu, China
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Xin F, Zhou X, Dong D, Zhao Z, Yang X, Wang Q, Gu Y, Kendrick KM, Chen A, Becker B. Oxytocin Differentially Modulates Amygdala Responses during Top-Down and Bottom-Up Aversive Anticipation. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2020; 7:2001077. [PMID: 32832361 PMCID: PMC7435249 DOI: 10.1002/advs.202001077] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/22/2020] [Indexed: 06/11/2023]
Abstract
The ability to successfully regulate negative emotions such as fear and anxiety is vital for mental health. Intranasal administration of the neuropeptide oxytocin (OXT) has been shown to reduce amygdala activity but to increase amygdala-prefrontal cortex connectivity during exposure to threatening stimuli suggesting that it may act as an important modulator of emotion regulation. The present randomized, between-subject, placebo-controlled pharmacological study combines the intranasal administration of OXT with functional magnetic resonance imaging (fMRI) during an explicit emotion regulation paradigm in 65 healthy male participants to investigate the modulatory effects of OXT on both bottom-up and top-down emotion regulation. OXT attenuates the activation in the posterior insular cortex and amygdala during anticipation of top-down regulation of predictable threat stimuli in participants with high trait anxiety. In contrast, OXT enhances amygdala activity during the bottom-up anticipation of unpredictable threat stimuli in participants with low trait anxiety. OXT may facilitate top-down goal-directed attention by attenuating amygdala activity in high anxiety individuals, while promoting bottom-up attention/vigilance to unexpected threats by enhancing amygdala activity in low anxiety individuals. OXT may thus have the potential to promote an adaptive balance between bottom-up and top-down attention systems depending on an individual's trait anxiety level.
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Affiliation(s)
- Fei Xin
- The Clinical Hospital of Chengdu Brain Science Institute MOE Key Laboratory for Neuroinformation University of Electronic Science and Technology of China Xiyuan Avenue 2006 Chengdu 611731 China
| | - Xinqi Zhou
- The Clinical Hospital of Chengdu Brain Science Institute MOE Key Laboratory for Neuroinformation University of Electronic Science and Technology of China Xiyuan Avenue 2006 Chengdu 611731 China
| | - Debo Dong
- The Clinical Hospital of Chengdu Brain Science Institute MOE Key Laboratory for Neuroinformation University of Electronic Science and Technology of China Xiyuan Avenue 2006 Chengdu 611731 China
| | - Zhongbo Zhao
- The Clinical Hospital of Chengdu Brain Science Institute MOE Key Laboratory for Neuroinformation University of Electronic Science and Technology of China Xiyuan Avenue 2006 Chengdu 611731 China
| | - Xi Yang
- The Clinical Hospital of Chengdu Brain Science Institute MOE Key Laboratory for Neuroinformation University of Electronic Science and Technology of China Xiyuan Avenue 2006 Chengdu 611731 China
| | - Qianqian Wang
- The Clinical Hospital of Chengdu Brain Science Institute MOE Key Laboratory for Neuroinformation University of Electronic Science and Technology of China Xiyuan Avenue 2006 Chengdu 611731 China
| | - Yan Gu
- Key Laboratory of Cognition and Personality Ministry of Education, Faculty of Psychology Southwest University Tiansheng Road 2 Chongqing 400715 China
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute MOE Key Laboratory for Neuroinformation University of Electronic Science and Technology of China Xiyuan Avenue 2006 Chengdu 611731 China
| | - Antao Chen
- Key Laboratory of Cognition and Personality Ministry of Education, Faculty of Psychology Southwest University Tiansheng Road 2 Chongqing 400715 China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute MOE Key Laboratory for Neuroinformation University of Electronic Science and Technology of China Xiyuan Avenue 2006 Chengdu 611731 China
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30
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Jones CE, Wickham PT, Lim MM. Early life sleep disruption is a risk factor for increased ethanol drinking after acute footshock stress in prairie voles. Behav Neurosci 2020; 134:424-434. [PMID: 32700922 DOI: 10.1037/bne0000410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Early postnatal experiences are important for shaping the development of the stress response and may contribute to the later emergence of alcohol use disorders. We have previously found that early life sleep disruption impairs social development and alters GABA neurons in the brain of adult prairie voles, a socially monogamous rodent that displays natural ethanol preference in the laboratory. However, it is unclear whether these effects on social behavior are due, in part, to overall anhedonia and/or altered behavioral response to stress. To address this question, litters containing prairie vole pups were sleep disrupted by gentle cage agitation for 7 consecutive days from postnatal days (P) 14 to 21 (early life sleep disruption, or ELSD group) or allowed to sleep undisturbed (Control). Adult voles underwent a 2-bottle choice ethanol drinking procedure integrated with a single session of footshocks. Ethanol intake after footshock was measured as well as c-Fos immunoreactivity in the lateral and central amygdala. ELSD animals showed increased ethanol consumption and increased neural activity in these amygdala regions after footshock compared to control animals. There were no differences in baseline ethanol drinking prior to exposure to a stressor. These results suggest that early life sleep disruption in prairie voles does not produce anhedonia but can have long-lasting effects on stress reactivity. In addition to shaping species-typical social behavior, early life sleep may be important in the development of stress induced ethanol consumption and the activation of limbic pathways associated with stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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31
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The electrophysiology correlation of the cognitive bias in anxiety under uncertainty. Sci Rep 2020; 10:11354. [PMID: 32647252 PMCID: PMC7347926 DOI: 10.1038/s41598-020-68427-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 06/24/2020] [Indexed: 11/17/2022] Open
Abstract
The intolerance of uncertainty (IU) model holds that excessive emotional response under uncertain conditions is conducive to the maintenance of anxiety, and individuals with a high anxiety level may exhibit a negative bias and experience anxiety when processing uncertain information. However, the dynamic electrophysiological correlation of this negative bias is not clear. Therefore, we used an adapted study–test paradigm to explore the changes in the electroencephalography (EEG) of subjects when processing uncertain cues and certain cues (certain neutral and certain threatening) and correlated the differences with anxiety level. The behavioral results showed that there was a significant positive correlation between the trait anxiety score and β value under the threatening condition, which indicated that individuals with high trait anxiety take a more conservative approach in the face of negative stimuli. The results of EEG showed that during the test stage, the components N1 and P2, which are related to early perception, had significant conditional main effects. Meanwhile, under uncertain conditions, the N1 peak was positively correlated with the state anxiety score. In the study stage, we found that the N400 component was significantly larger in the early study stage than in the late study stage under uncertain conditions. In sum, individuals with high anxiety levels had a negative bias in the early cue processing of the test stage, and anxiety did not affect the study stage.
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32
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Pedersen WS, Muftuler LT, Larson CL. A high-resolution fMRI investigation of BNST and centromedial amygdala activity as a function of affective stimulus predictability, anticipation, and duration. Soc Cogn Affect Neurosci 2020; 14:1167-1177. [PMID: 31820811 PMCID: PMC7057282 DOI: 10.1093/scan/nsz095] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/16/2019] [Accepted: 11/12/2019] [Indexed: 12/21/2022] Open
Abstract
Relative to the centromedial amygdala (CM), the bed nucleus of the stria terminalis (BNST) may exhibit more sustained activation toward threat, sensitivity to unpredictability and activation during anxious anticipation. These factors are often intertwined. For example, greater BNST (vs CM) activation during a block of aversive stimuli may reflect either more sustained activation to the stimuli or greater activation due to the anticipation of upcoming stimuli. To further investigate these questions, we had participants (19 females, 9 males) complete a task adapted from a study conducted by Somerville, Whalen and Kelly in 2013, during high-resolution 7-Tesla fMRI BOLD acquisition. We found a larger response to negative vs neutral blocks (sustained threat) than to images (transient) in the BNST, but not the CM. However, in an additional analysis, we also found BNST, but not CM, activation to the onset of the anticipation period on negative vs neutral trials, possibly contributing to BNST activation across negative blocks. Predictability did not affect CM or BNST activation. These results suggest a BNST role in anxious anticipation and highlight the need for further research clarifying the temporal response characteristics of these regions.
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33
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Fee C, Prevot T, Misquitta K, Banasr M, Sibille E. Chronic Stress-induced Behaviors Correlate with Exacerbated Acute Stress-induced Cingulate Cortex and Ventral Hippocampus Activation. Neuroscience 2020; 440:113-129. [PMID: 32473277 DOI: 10.1016/j.neuroscience.2020.05.034] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/17/2020] [Accepted: 05/19/2020] [Indexed: 12/28/2022]
Abstract
Altered activity of corticolimbic brain regions is a hallmark of stress-related illnesses, including mood disorders, neurodegenerative diseases, and substance abuse disorders. Acute stress adaptively recruits brain region-specific functions for coping, while sustained activation under chronic stress may overwhelm feedback mechanisms and lead to pathological cellular and behavioral responses. The neural mechanisms underlying dysregulated stress responses and how they contribute to behavioral deficits are poorly characterized. Here, we tested whether prior exposure to chronic restraint stress (CRS) or unpredictable chronic mild stress (UCMS) in mice could alter functional response to acute stress and whether these changes are associated with chronic stress-induced behavioral deficits. More specifically, we assessed acute stress-induced functional activation indexed by c-Fos+ cell counts in 24 stress- and mood-related brain regions, and determined if changes in functional activation were linked to chronic stress-induced behavioral impairments, summarized across dimensions through principal component analysis (PCA). Results indicated that CRS and UCMS led to convergent physiological and anxiety-like deficits, whereas working and short-term memory were impaired only in UCMS mice. CRS and UCMS exposure exacerbated functional activation by acute stress in anterior cingulate cortex (ACC) area 24b and ventral hippocampal (vHPC) CA1, CA3, and subiculum. In dysregulated brain regions, levels of functional activation were positively correlated with principal components reflecting variance across behavioral deficits relevant to stress-related disorders. Our data supports an association between a dysregulated stress response, altered functional corticolimbic excitation/inhibition balance, and the expression of maladaptive behaviors.
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Affiliation(s)
- Corey Fee
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Thomas Prevot
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Keith Misquitta
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Mounira Banasr
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Etienne Sibille
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Wise T, Patrick F, Meyer N, Mazibuko N, Oates AE, van der Bijl AH, Danjou P, O’Connor SM, Doolin E, Wooldridge C, Rathjen D, Macare C, Williams SC, Perkins A, Young AH. Cholinergic Modulation of Disorder-Relevant Neural Circuits in Generalized Anxiety Disorder. Biol Psychiatry 2020; 87:908-915. [PMID: 32107005 PMCID: PMC7198974 DOI: 10.1016/j.biopsych.2019.12.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/25/2019] [Accepted: 12/11/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Generalized anxiety disorder is associated with hyperactivity in the amygdala-prefrontal networks, and normalization of this aberrant function is thought to be critical for successful treatment. Preclinical evidence implicates cholinergic neurotransmission in the function of these systems and suggests that cholinergic modulation may have anxiolytic effects. However, the effects of cholinergic modulators on the function of anxiety-related networks in humans have not been investigated. METHODS We administered a novel α7 nicotinic acetylcholine receptor-negative allosteric modulator, BNC210, to 24 individuals (3 male subjects) with generalized anxiety disorder and assessed its effects on neural responses to fearful face stimuli. RESULTS BNC210 reduced amygdala reactivity to fearful faces relative to placebo and similarly to lorazepam and also reduced connectivity between the amygdala and the anterior cingulate cortex, a network involved in regulating anxious responses to aversive stimuli. CONCLUSIONS These results demonstrate for the first time that the function of disorder-relevant neural circuits in generalized anxiety disorder can be beneficially altered through modulation of cholinergic neurotransmission and suggest potential for this system as a novel target for anxiolytic pharmacotherapy.
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Affiliation(s)
- Toby Wise
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Wellcome Trust Centre for Neuroimaging, University College London, London, UK; Max Planck UCL Centre for Computational Psychiatry and Ageing Research, London, UK; Department of Humanities and Social Sciences, California Institute of Technology, Pasadena, California.
| | - Fiona Patrick
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Nicholas Meyer
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Ndaba Mazibuko
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | | | | | | | | | | | - Caroline Wooldridge
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | | | - Christine Macare
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Steven C.R. Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,National Institute for Health Research Biomedical Research Centre, South London, London, UK
| | - Adam Perkins
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,National Institute for Health Research Biomedical Research Centre, South London, London, UK
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,National Institute for Health Research Biomedical Research Centre, South London, London, UK
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Braithwaite JJ, Watson DG, Dewe H. The Body-Threat Assessment Battery (BTAB): A new instrument for the quantification of threat-related autonomic affective responses induced via dynamic movie clips. Int J Psychophysiol 2020; 155:16-31. [PMID: 32387395 DOI: 10.1016/j.ijpsycho.2020.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 04/09/2020] [Accepted: 04/20/2020] [Indexed: 11/26/2022]
Abstract
We present a new instrument for the assessment of responses to threat-related imagery directed towards a human body - the Body-Threat Assessment Battery (BTAB). The BTAB consists of a series of high-definition dynamic clips depicting body-threats and matched non-threat baseline behaviours. For body-threat stimuli a perspective manipulation was included to assess the effects of viewing threats from the point-of-view of the observer (POV) or from an external/exocentric perspective (EXO). Green-screen technology was used so that extraneous background information could be removed and standardised in post-production. Categorical normative data for psychological ratings (valence, arousal and pain), psychophysiological, phasic skin conductance responses (SCRs) and tonic skin conductance levels (SCLs) were obtained for all stimuli. Body-threat stimuli evoked significantly higher psychological ratings of arousal and pain, with more negative ratings of valence, relative to baseline stimuli. In addition, threat stimuli also had an increased efficacy at evoking SCRs, and these were significantly stronger relative to baseline stimuli. There were no effects of perspective on psychophysiological or psychological responses to threat imagery. The findings are discussed in the context of the utility and scope of the BTAB for supporting neurocognitive investigations of aversive imagery and body-threats specifically in the study of embodiment, body-processing and self-consciousness.
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Affiliation(s)
| | | | - Hayley Dewe
- Department of Psychology, Durham University, DH1 3LE, UK
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36
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Gold AL, Abend R, Britton JC, Behrens B, Farber M, Ronkin E, Chen G, Leibenluft E, Pine DS. Age Differences in the Neural Correlates of Anxiety Disorders: An fMRI Study of Response to Learned Threat. Am J Psychiatry 2020; 177:454-463. [PMID: 32252541 PMCID: PMC9078083 DOI: 10.1176/appi.ajp.2019.19060650] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Although both pediatric and adult patients with anxiety disorders exhibit similar neural responding to threats, age-related differences have been found in some functional MRI (fMRI) studies. To reconcile disparate findings, the authors compared brain function in youths and adults with and without anxiety disorders while rating fear and memory of ambiguous threats. METHODS Two hundred medication-free individuals ages 8-50 were assessed, including 93 participants with an anxiety disorder. Participants underwent discriminative threat conditioning and extinction in the clinic. Approximately 3 weeks later, they completed an fMRI paradigm involving extinction recall, in which they rated their levels of fear evoked by, and their explicit memory for, morph stimuli with varying degrees of similarity to the extinguished threat cues. RESULTS Age moderated two sets of anxiety disorder findings. First, as age increased, healthy subjects compared with participants with anxiety disorders exhibited greater amygdala-ventromedial prefrontal cortex (vmPFC) connectivity when processing threat-related cues. Second, age moderated diagnostic differences in activation in ways that varied with attention and brain regions. When rating fear, activation in the vmPFC differed between the anxiety and healthy groups at relatively older ages. In contrast, when rating memory for task stimuli, activation in the inferior temporal cortex differed between the anxiety and healthy groups at relatively younger ages. CONCLUSIONS In contrast to previous studies that demonstrated age-related similarities in the biological correlates of anxiety disorders, this study identified age differences. These findings may reflect this study's focus on relatively late-maturing psychological processes, particularly the appraisal and explicit memory of ambiguous threat, and inform neurodevelopmental perspectives on anxiety.
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Affiliation(s)
- Andrea L. Gold
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, and Pediatric Anxiety Research Center, Bradley Hospital, Riverside, R.I
| | - Rany Abend
- Emotion and Development Branch, NIMH, Bethesda, Md
| | | | | | | | - Emily Ronkin
- Emotion and Development Branch, NIMH, Bethesda, Md
| | - Gang Chen
- Scientific and Statistical Computing Core, NIMH, Bethesda, Md
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Valenza G, Passamonti L, Duggento A, Toschi N, Barbieri R. Uncovering complex central autonomic networks at rest: a functional magnetic resonance imaging study on complex cardiovascular oscillations. J R Soc Interface 2020; 17:20190878. [PMID: 32183642 DOI: 10.1098/rsif.2019.0878] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This study aims to uncover brain areas that are functionally linked to complex cardiovascular oscillations in resting-state conditions. Multi-session functional magnetic resonance imaging (fMRI) and cardiovascular data were gathered from 34 healthy volunteers recruited within the human connectome project (the '100-unrelated subjects' release). Group-wise multi-level fMRI analyses in conjunction with complex instantaneous heartbeat correlates (entropy and Lyapunov exponent) revealed the existence of a specialized brain network, i.e. a complex central autonomic network (CCAN), reflecting what we refer to as complex autonomic control of the heart. Our results reveal CCAN areas comprised the paracingulate and cingulate gyri, temporal gyrus, frontal orbital cortex, planum temporale, temporal fusiform, superior and middle frontal gyri, lateral occipital cortex, angular gyrus, precuneous cortex, frontal pole, intracalcarine and supracalcarine cortices, parahippocampal gyrus and left hippocampus. The CCAN visible at rest does not include the insular cortex, thalamus, putamen, amygdala and right caudate, which are classical CAN regions peculiar to sympatho-vagal control. Our results also suggest that the CCAN is mainly involved in complex vagal control mechanisms, with possible links with emotional processing networks.
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Affiliation(s)
- Gaetano Valenza
- Bioengineering and Robotics Research Centre 'E. Piaggio', University of Pisa, Pisa, Italy.,Deparment of Information Engineering, University of Pisa, Pisa, Italy
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, Milano, Italy.,Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Andrea Duggento
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy
| | - Riccardo Barbieri
- Department of Electronics, Informatics and Bioengineering, Politecnico di Milano, Milano, Italy
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An integrative analysis of 5HTT-mediated mechanism of hyperactivity to non-threatening voices. Commun Biol 2020; 3:113. [PMID: 32157156 PMCID: PMC7064530 DOI: 10.1038/s42003-020-0850-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/21/2020] [Indexed: 01/24/2023] Open
Abstract
The tonic model delineating the serotonin transporter polymorphism’s (5-HTTLPR) modulatory effect on anxiety points towards a universal underlying mechanism involving a hyper-or-elevated baseline level of arousal even to non-threatening stimuli. However, to our knowledge, this mechanism has never been observed in non-clinical cohorts exhibiting high anxiety. Moreover, empirical support regarding said association is mixed, potentially because of publication bias with a relatively small sample size. Hence, how the 5-HTTLPR modulates neural correlates remains controversial. Here we show that 5-HTTLPR short-allele carriers had significantly increased baseline ERPs and reduced fearful MMN, phenomena which can nevertheless be reversed by acute anxiolytic treatment. This provides evidence that the 5-HTT affects the automatic processing of threatening and non-threatening voices, impacts broadly on social cognition, and conclusively asserts the heightened baseline arousal level as the universal underlying neural mechanism for anxiety-related susceptibilities, functioning as a spectrum-like distribution from high trait anxiety non-patients to anxiety patients. Chen et al. apply a multi-level approach to show that serotonin signaling modulates neuronal responses to both threatening and non-threatening voices even in the pre-attentive stage. They show that 5-HTTLPR short-allele carriers had higher baseline event-related potentials and lower fearful mismatch negativity, which can be reversed by acute anxiolytic treatment.
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Personalized Clinical Approaches to Anxiety Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:489-521. [DOI: 10.1007/978-981-32-9705-0_25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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40
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Santiago J, Akeman E, Kirlic N, Clausen AN, Cosgrove KT, McDermott TJ, Mathis B, Paulus M, Craske MG, Abelson J, Martell C, Wolitzky-Taylor K, Bodurka J, Thompson WK, Aupperle RL. Protocol for a randomized controlled trial examining multilevel prediction of response to behavioral activation and exposure-based therapy for generalized anxiety disorder. Trials 2020; 21:17. [PMID: 31907032 PMCID: PMC6943897 DOI: 10.1186/s13063-019-3802-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/11/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Only 40-60% of patients with generalized anxiety disorder experience long-lasting improvement with gold standard psychosocial interventions. Identifying neurobehavioral factors that predict treatment success might provide specific targets for more individualized interventions, fostering more optimal outcomes and bringing us closer to the goal of "personalized medicine." Research suggests that reward and threat processing (approach/avoidance behavior) and cognitive control may be important for understanding anxiety and comorbid depressive disorders and may have relevance to treatment outcomes. This study was designed to determine whether approach-avoidance behaviors and associated neural responses moderate treatment response to exposure-based versus behavioral activation therapy for generalized anxiety disorder. METHODS/DESIGN We are conducting a randomized controlled trial involving two 10-week group-based interventions: exposure-based therapy or behavioral activation therapy. These interventions focus on specific and unique aspects of threat and reward processing, respectively. Prior to and after treatment, participants are interviewed and undergo behavioral, biomarker, and neuroimaging assessments, with a focus on approach and avoidance processing and decision-making. Primary analyses will use mixed models to examine whether hypothesized approach, avoidance, and conflict arbitration behaviors and associated neural responses at baseline moderate symptom change with treatment, as assessed using the Generalized Anxiety Disorder-7 item scale. Exploratory analyses will examine additional potential treatment moderators and use data reduction and machine learning methods. DISCUSSION This protocol provides a framework for how studies may be designed to move the field toward neuroscience-informed and personalized psychosocial treatments. The results of this trial will have implications for approach-avoidance processing in generalized anxiety disorder, relationships between levels of analysis (i.e., behavioral, neural), and predictors of behavioral therapy outcome. TRIAL REGISTRATION The study was retrospectively registered within 21 days of first participant enrollment in accordance with FDAAA 801 with ClinicalTrials.gov, NCT02807480. Registered on June 21, 2016, before results.
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Affiliation(s)
- J Santiago
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK, 74136, USA
| | - E Akeman
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK, 74136, USA
| | - N Kirlic
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK, 74136, USA
| | - A N Clausen
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Duke University Brain Imaging and Analysis Center, Durham, NC, USA
| | - K T Cosgrove
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK, 74136, USA
- Department of Psychology, University of Tulsa, Tulsa, OK, USA
| | - T J McDermott
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK, 74136, USA
- Department of Psychology, University of Tulsa, Tulsa, OK, USA
| | - B Mathis
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK, 74136, USA
| | - M Paulus
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK, 74136, USA
- School of Community Medicine, University of Tulsa, Tulsa, OK, USA
| | - M G Craske
- Psychology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - J Abelson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - C Martell
- Department of Psychological and Brain Sciences, University of Massachusetts-Amherst, Amherst, MA, USA
| | - K Wolitzky-Taylor
- Psychology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - J Bodurka
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK, 74136, USA
- Stephenson School of Biomedical Engineering, The University of Oklahoma, Norman, OK, USA
| | - W K Thompson
- Family Medicine and Public Health, University of California, San Diego, San Diego, CA, USA
| | - Robin L Aupperle
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK, 74136, USA.
- School of Community Medicine, University of Tulsa, Tulsa, OK, USA.
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Cosci F, Mansueto G. Biological and Clinical Markers to Differentiate the Type of Anxiety Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:197-218. [PMID: 32002931 DOI: 10.1007/978-981-32-9705-0_13] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The present chapter is an overview of possible biomarkers which distinguish anxiety disorders as classified by the DSM-5. Structural or activity changes in the brain regions; changes in N-acetylaspartate/creatine, dopamine, serotonin, and oxytocin; hearth rate variability; hypothalamic-pituitary-adrenal axis activity; error-related negativity; respiratory regulation; and genetic variants are proposed. However, their clinical utility is questionable due to low specificity and sensitivity: the majority does not distinguish subjects with different anxiety disorders, and they might be influenced by stress, comorbidity, physical activity, and psychotropic medications. In this framework, the staging model, a clinimetric tool which allows to define the degree of progression of a disease at a point in time and where the patient is located on the continuum of the course of the disease, is proposed since several DSM anxiety disorders take place at different stages of the same syndrome according to the staging model. Thus, a stage-specific biomarker model for anxiety disorders is hypothesized and illustrated.
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Affiliation(s)
- Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy. .,Maastricht University Medical Center, Department of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, The Netherlands.
| | - Giovanni Mansueto
- Department of Health Sciences, University of Florence, Florence, Italy.,Maastricht University Medical Center, Department of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, The Netherlands
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Tomasi J, Lisoway AJ, Zai CC, Harripaul R, Müller DJ, Zai GCM, McCabe RE, Richter MA, Kennedy JL, Tiwari AK. Towards precision medicine in generalized anxiety disorder: Review of genetics and pharmaco(epi)genetics. J Psychiatr Res 2019; 119:33-47. [PMID: 31563039 DOI: 10.1016/j.jpsychires.2019.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/15/2019] [Accepted: 09/05/2019] [Indexed: 02/06/2023]
Abstract
Generalized anxiety disorder (GAD) is a prevalent and chronic mental disorder that elicits widespread functional impairment. Given the high degree of non-response/partial response among patients with GAD to available pharmacological treatments, there is a strong need for novel approaches that can optimize outcomes, and lead to medications that are safer and more effective. Although investigations have identified interesting targets predicting treatment response through pharmacogenetics (PGx), pharmaco-epigenetics, and neuroimaging methods, these studies are often solitary, not replicated, and carry several limitations. This review provides an overview of the current status of GAD genetics and PGx and presents potential strategies to improve treatment response by combining better phenotyping with PGx and improved analytical methods. These strategies carry the dual benefit of delivering data on biomarkers of treatment response as well as pointing to disease mechanisms through the biology of the markers associated with response. Overall, these efforts can serve to identify clinical, genetic, and epigenetic factors that can be incorporated into a pharmaco(epi)genetic test that may ultimately improve treatment response and reduce the socioeconomic burden of GAD.
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Affiliation(s)
- Julia Tomasi
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Amanda J Lisoway
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Clement C Zai
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ricardo Harripaul
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Molecular Neuropsychiatry & Development (MiND) Lab, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Daniel J Müller
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Gwyneth C M Zai
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; General Adult Psychiatry and Health Systems Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Randi E McCabe
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Margaret A Richter
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Frederick W. Thompson Anxiety Disorders Centre, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - James L Kennedy
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Arun K Tiwari
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Abstract
The application of personalized medicine to psychiatry is challenging. Psychoradiology could provide biomarkers based on objective tests in support of the diagnostic classifications and treatment planning. We review potential psychoradiological biomarkers for psychopharmaceutical effects. Although none of the biomarkers reviewed are yet of sufficient clinical utility to inform the selection of a specific pharmacologic compound for an individual patient, there is strong consensus that advanced multimodal approaches will contribute to discovery of novel treatment predictors in psychiatric disorders. Progress has been sufficient to warrant enthusiasm, in which application of neuroimaging-based biomarkers would represent a paradigm shift and modernization of psychiatric practice.
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Kolesar TA, Bilevicius E, Wilson AD, Kornelsen J. Systematic review and meta-analyses of neural structural and functional differences in generalized anxiety disorder and healthy controls using magnetic resonance imaging. NEUROIMAGE-CLINICAL 2019; 24:102016. [PMID: 31835287 PMCID: PMC6879983 DOI: 10.1016/j.nicl.2019.102016] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/22/2019] [Accepted: 09/27/2019] [Indexed: 12/18/2022]
Abstract
PFC-amygdala FC is altered in GAD, indicating top-down processing deficits. GAD had reduced activity for emotion regulation and working memory in the culmen. Salience, default, and central executive nodes have altered structure and function.
Objective To compare structure, functional connectivity (FC) and task-based neural differences in subjects with generalized anxiety disorder (GAD) compared to healthy controls (HC). Methods The Embase, Ovid Medline, PsycINFO, Scopus, and Web of Science databases were searched from inception until March 12, 2018. Two reviewers independently screened titles, abstracts, and full-text articles. Data were extracted from records directly contrasting GAD and HC that included structure (connectivity and local indices such as volume, etc.), FC, or task-based magnetic resonance imaging data. Meta-analyses were conducted, as applicable, using AES-SDM software. Results The literature search produced 4,645 total records, of which 85 met the inclusion criteria for the systematic review. Records included structural (n = 35), FC (n = 33), and task-based (n = 42) findings. Meta-analyses were conducted on voxel-based morphometry and task-based results. Discussion The systematic review confirms and extends findings from previous reviews. Although few whole-brain resting state studies were conducted, key nodes of resting state networks have altered physiology: the hippocampus (default network), ACC and amygdala (salience network), have reduced volume, and the dlPFC (central executive network) and ACC have reduced FC with the amygdala in GAD. Nodes in the sensorimotor network are also altered with greater pre- and postcentral volume, reduced supplementary motor area volume, and reduced FC in anterior and increased FC in posterior cerebellum. Conclusions Despite limitations due to sample size, the meta-analyses highly agree with the systematic review and provide evidence of widely distributed neural differences in subjects with GAD, compared to HC. Further research optimized for meta-analyses would greatly improve large-scale comparisons.
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Affiliation(s)
- Tiffany A Kolesar
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada
| | - Elena Bilevicius
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Alyssia D Wilson
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer Kornelsen
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada; Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Radiology, University of Manitoba, Winnipeg, MB, Canada.
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Wu M, Mennin DS, Ly M, Karim HT, Banihashemi L, Tudorascu DL, Aizenstein HJ, Andreescu C. When worry may be good for you: Worry severity and limbic-prefrontal functional connectivity in late-life generalized anxiety disorder. J Affect Disord 2019; 257:650-657. [PMID: 31357162 PMCID: PMC6711791 DOI: 10.1016/j.jad.2019.07.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 05/31/2019] [Accepted: 07/04/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Late-life generalized anxiety disorder (GAD) is one of the most common anxiety disorders in older adults. However, its neural markers have received relatively little attention. In this study, we explored the association between worry severity and limbic-prefrontal connectivity during emotional reactivity in late-life GAD. METHODS We recruited 16 anxious (GAD) and 20 non-anxious (HC) older adults to perform the faces/shapes emotional reactivity task during functional magnetic resonance imaging (fMRI). We investigated the functional connectivity of both the amygdala and the bed nucleus of stria terminalis (BNST) with the prefrontal cortex (PFC) using generalized psychophysiological interaction (gPPI) analysis. We tested for (1) group differences in connectivity, (2) association between worry severity and connectivity, and (3) interaction between group and worry severity and its association with connectivity. RESULTS Amygdala-PFC and BNST-PFC functional connectivity were associated with worry severity in an inverse U-shape, and was independent of depression severity, global anxiety, neuroticism, and general cognitive function. LIMITATIONS Our limitations include slightly skewed PSWQ distributions, lack of non-anxious individuals with high worry, small sample size, and low depression comorbidity in a sample of late-life GAD that may not generalize to GAD in younger populations. CONCLUSIONS This suggests that moderate worry is associated with maximum engagement of the limbic-PFC connectivity, while severe worry is associated with failure of the limbic-PFC emotional regulation circuit. This may explain the aberrant and exaggerated responses to negative stimuli observed in participants with pathological worry.
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Affiliation(s)
- M Wu
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - DS Mennin
- Teachers college, Columbia University, New York City, NY
| | - M Ly
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - HT Karim
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - L Banihashemi
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - DL Tudorascu
- Department of Internal Medicine, Graduate School of Public health, Pittsburgh, PA,Department of Biostatistics, Graduate School of Public Health, Pittsburgh, PA
| | - HJ Aizenstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
| | - C Andreescu
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Park C, Rosenblat JD, Lee Y, Pan Z, Cao B, Iacobucci M, McIntyre RS. The neural systems of emotion regulation and abnormalities in major depressive disorder. Behav Brain Res 2019; 367:181-188. [DOI: 10.1016/j.bbr.2019.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/06/2019] [Accepted: 04/01/2019] [Indexed: 12/13/2022]
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Goossen B, van der Starre J, van der Heiden C. A review of neuroimaging studies in generalized anxiety disorder: "So where do we stand?". J Neural Transm (Vienna) 2019; 126:1203-1216. [PMID: 31222605 DOI: 10.1007/s00702-019-02024-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 05/27/2019] [Indexed: 12/20/2022]
Abstract
Generalized anxiety disorder (GAD) is a prevalent anxiety disorder, but is still poorly recognized in clinical practice. The aim of this review is to provide a coherent understanding of the functional neuroanatomy of GAD; second, to discuss the current theoretical cognitive models surrounding GAD; and finally to discuss the discrepancy between fundamental research and clinical practice and highlight several potential directions for future research in this domain. A systematic review of original papers investigating the neural correlates of DSM-IV and DSM-5 defined GAD samples was undertaken in Ovid literature search, PubMed, Medline, EMbase, PsycINFO, Google Scholar, and TRIP databases. Articles published between 2007 and 2018 were included. First, GAD seems to be characterized by limbic and (pre)frontal abnormalities. More specifically, GAD patients show difficulties in engaging the prefrontal cortex (PFC) and anterior cingulate cortex (ACC) during emotional regulation tasks. Second, the involved brain areas appear to be characterized by heterogeneity possibly due to a variety of experimental designs and test subjects. Third, regarding the discrimination between GAD and other anxiety disorders via fMRI, results appear to be mixed. Studies report both GAD-specific activity and an inability to differentiate between GAD and other anxiety or mood disorders. The usage of different experimental tasks, test subjects, outcome measures and experimental designs limits the possibilities of generalizing results as well as conducting meta-analytical research. Certain theoretical models of GAD describe our understanding of this disorder and form the basis for treatment interventions. However, fMRI research thus far has failed to validate these models. To bridge the gap between fundamental research and clinical practice in GAD, we propose that fMRI researchers make an effort to validate the existing cognitive model of GAD. An alternative approach could be that new models would be based on current neuroimaging research as well as convergent research methods such as Heart Rate Variability (a bottom up approach).
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Affiliation(s)
- Bastiaan Goossen
- Outpatient Treatment Center GGZ Delfland, Sint Jorisweg 2, 2612 GA, Delft, The Netherlands.
| | | | - Colin van der Heiden
- Outpatient Treatment Center Indigo, Spijkenisse, The Netherlands.,Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Madonna D, Delvecchio G, Soares JC, Brambilla P. Structural and functional neuroimaging studies in generalized anxiety disorder: a systematic review. ACTA ACUST UNITED AC 2019; 41:336-362. [PMID: 31116259 PMCID: PMC6804309 DOI: 10.1590/1516-4446-2018-0108] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/16/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Brain imaging studies carried out in patients suffering from generalized anxiety disorder (GAD) have contributed to better characterize the pathophysiological mechanisms underlying this disorder. The present study reviews the available functional and structural brain imaging evidence on GAD, and suggests further strategies for investigations in this field. METHODS A systematic literature review was performed in PubMed, PsycINFO, and Google Scholar, aiming to identify original research evaluating GAD patients with the use of structural and functional magnetic resonance imaging as well as diffusion tensor imaging. RESULTS The available studies have shown impairments in ventrolateral and dorsolateral prefrontal cortex, anterior cingulate, posterior parietal regions, and amygdala in both pediatric and adult GAD patients, mostly in the right hemisphere. However, the literature is often tentative, given that most studies have employed small samples and included patients with comorbidities or in current use of various medications. Finally, different methodological aspects, such as the type of imaging equipment used, also complicate the generalizability of the findings. CONCLUSIONS Longitudinal neuroimaging studies with larger samples of both juvenile and adult GAD patients, as well as at risk individuals and unaffected relatives, should be carried out in order to shed light on the specific biological signature of GAD.
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Affiliation(s)
- Domenico Madonna
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Universitá di Milano, Milano, Italy.,Dipartimento di Neuroscienze e Salute Mentale, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giuseppe Delvecchio
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Universitá di Milano, Milano, Italy
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Paolo Brambilla
- Dipartimento di Neuroscienze e Salute Mentale, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Psychiatry and Behavioral Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
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Wang W, Peng Z, Wang X, Wang P, Li Q, Wang G, Chen F, Chen X, Liu S. Disrupted interhemispheric resting-state functional connectivity and structural connectivity in first-episode, treatment-naïve generalized anxiety disorder. J Affect Disord 2019; 251:280-286. [PMID: 30953893 DOI: 10.1016/j.jad.2019.03.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/25/2019] [Accepted: 03/29/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Aberrant functional and structural connectivity are considered to be involved in the underlying neural mechanism of generalized anxiety disorder (GAD). However, alterations in functional and structural interactions between the bilateral hemispheres are rarely examined. The current study aimed to characterized interhemispheric resting-state functional connectivity and white matter microstructural integrity of the corpus callosum in patients with GAD. METHODS Resting-state Blood oxygen level-dependent and diffusion tensor image were acquired for patients with GAD and healthy subjects. The two groups were matched in age, gender, education years. The voxel-mirrored homotopic connectivity (VMHC) of whole brain and white matter integrity of the corpus callosum (CC) were compared between the two groups. Their correlations with clinical measures were further performed. RESULTS Compare to controls, decreased resting-state VMHC were found in the precentral gyrus, middle cingulate gyrus and insula/putamen in patients with GAD. No regions of increased VMHC were detected in GAD. Compared to controls, GAD patients showed decreased fractional anisotropy (FA) values in CC2. In GAD group, further Pearson's correlation analyses showed that VMHC of the midcingulate gyrus positively correlated with FA of CC2, FA of CC2 negatively correlated with anxiety severity. Further mediation analyses demonstrated that attenuated VMHC in bilateral midcingulate gyrus partly mediated the association between white matter integrity of CC2 sub-region and anxiety severity. CONCLUSION Our findings suggested impairment of interhemispheric coordination in GAD. Moreover, disrupted interhemispheric connectivity correlated with anxiety severity in GAD. Our findings provided a novel clue about the neural mechanism of GAD, and may contribute to further deep exploration and treatment of GAD. LIMITATIONS The study was lack of comparison with non-GAD anxiety disorders.
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Affiliation(s)
- Wei Wang
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China; 71282 Hospital, Baoding 071052, China
| | - Zhaohui Peng
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China; Department of Radilogy, The 960th Hospital of the PLA Joint Logistice Support Force, Jinan, Shandong Province 250031, China
| | - Xiang Wang
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | - Peng Wang
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | - Qingchu Li
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | - Gang Wang
- The Second Community Healthcare Service Center of Zhengzhou Road, Luoyang 471000, China
| | - Fangni Chen
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | | | - Shiyuan Liu
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China.
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Dennis-Tiwary TA, Roy AK, Denefrio S, Myruski S. Heterogeneity of the Anxiety-Related Attention Bias: A Review and Working Model for Future Research. Clin Psychol Sci 2019; 7:879-899. [PMID: 33758680 DOI: 10.1177/2167702619838474] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The anxiety-related attention bias (AB) has been studied for several decades as a clinically-relevant output of the dynamic and complex threat detection-response system. Despite research enthusiasm for the construct of AB, current theories and measurement approaches cannot adequately account for the growing body of mixed, contradictory, and null findings. Drawing on clinical, neuroscience, and animal models, we argue that the apparent complexity and contradictions in the empirical literature can be attributed to the field's failure to clearly conceptualize AB heterogeneity and the dearth of studies in AB that consider additional cognitive mechanisms in anxiety, particularly disruptions in threat-safety discrimination and cognitive control. We review existing research and propose a working model of AB heterogeneity positing that AB may be best conceptualized as multiple subtypes of dysregulated processing of and attention to threat anchored in individual differences in threat-safety discrimination and cognitive control. We review evidence for this working model and discuss how it can be used to advance knowledge of AB mechanisms and inform personalized prevention and intervention approaches.
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Affiliation(s)
- Tracy A Dennis-Tiwary
- Hunter College, The City University of New York, Department of Psychology, New York, NY.,The Graduate Center, The City University of New York, Department of Psychology, New York, NY
| | - Amy Krain Roy
- Fordham University, Department of Psychology, Bronx, NY.,New York University Langone School of Medicine, Department of Child and Adolescent Psychiatry, New York, NY
| | - Samantha Denefrio
- The Graduate Center, The City University of New York, Department of Psychology, New York, NY.,Hunter College, The City University of New York, Department of Psychology, New York, NY
| | - Sarah Myruski
- Hunter College, The City University of New York, Department of Psychology, New York, NY
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